Full Name
*
First Name
Last Name
Phone Number
*
Business Email
*
example@example.com
Business Name
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your Resale Certificate or EIN number?
*
Industry Business Type
*
Agriculture
Education
Construction/Utilities/Contracting
Finance & Insurance
Food & Hospitality
Gaming
Health Services
Motor Vehicle
Natural Resources/Environmental
Other
Personal Services
Real Estate & Housing
Safety/Security & Legal
Transportation
Business Url
Website
Social Media Handle(Instagram/Facebook)
We require a minimum order quantity of $500.00 per transaction. Are you able to invest $500.00?
*
Please Select
YES
NO
How many different products are you intending on wholesaling?
*
1-5
5-10
10-15
When are you intending to sell our products?
-
Year
-
Month
Day
Date
Will you be carrying herbal tea brands other than "Upful Blends" in your business/event?
Please Select
YES
NO
If this is for an event please give us more information about the event including date, location, target audience, and purpose.
Upload two of the following documents: Proof of Business Ownership and Unexpired Government-Issued ID
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: